Poster Presentation

High-fidelity Simulations for First Responders: Addressing Health Equity Through Enhanced Prehospital Obstetric and Neonatal Care

- CDT
Room: Grand Central Foyer
Megan Falke, DNP, APRN, NNP-BC
Creighton University
Catherine Enenbach, MSN-Ed, RN, C-EFM
Creighton University
Dan Dan profile pic
Dan Stein, MS EMS, NRP
Creighton University
Lucas Palacio, CCP-C
Creighton University
Track:
  • Innovative Approaches to Interprofessional Pedagogy and Education Science
Session handout: Log in to view the attachment.
Prehospital obstetrical or neonatal (OB/Neo) calls to emergency medical services (EMS) are more likely among patients of lower socioeconomic status and to result in an OB/Neo emergency. Paramedicine faculty have expressed the need for paramedic learners (PML) to increase confidence in these skills to promote health equity and improve maternal and neonatal health outcomes. Limited literature in use of simulation-based experiences (SBE) in prehospital settings have demonstrated improved confidence among EMS and the Zone of Simulation framework, indicates these scenarios fall into the high acuity-low occurrence quadrant, suggesting SBE may be advantageous over instruction.Goals, objectives, and purpose: Apply knowledge of childbirth, and the role the EMS practitioner has in facilitating prehospital childbirth.

Integrate the routine management of the neonate, and resuscitation.

Identify the types of obstetrical and neonatal complications and the EMS practitioner’s approach to these emergencies.

A team of nursing and paramedicine faculty worked with simulation staff to design OB/Neo emergency SBEs for PMLs.Methods/Methodology: PMLs learners (n=13) participated in didactic on normal vaginal delivery, breech presentation, neonatal resuscitation, and handoff communication before rotating through four OB/Neo emergency SBE stations: application of OB/Neo skills with one normal vaginal simulation, two complex deliveries, and one combined OB/Neo scenario, followed by a group debrief. Confidence was assessed using nine item Likert scale and two open-ended questions on a computer-based survey.Results/Findings: Learners were surveyed two months following completion of SBE. All stated they had some experience with OB/Neo emergencies prior to the SBE, but endorsed SBE as helpful to their professional practice and improved skill confidence. Debriefing was also emphasized as a helpful simulation tool, two general themes emerged: importance of controlling the environment and therapeutic communication with OB/Neo patients.Conclusions, implications, and/or curiosities: High-fidelity SBE improves confidence for learners in OB/Neo emergency situations.

Using evidence-based CCEI 2.0 tool for paramedicine learners

Future IPE simulation with nursing, NNP and paramedicine

References

  • Chiniara, G., Cole, G., Brisbin, K., Huffman, D., Cragg, B., Lamacchia, M., & Norman, D. (2013). Simulation in healthcare: A taxonomy and a conceptual framework for instructional design and media selection. Medical Teacher, 35(8), e1380–e1395. https://doi.org/10.3109/0142159X.2012.733451
  • Douglas County Health Department. (2020). Fetal and infant mortality review (FIMR) 2019-2020 community report. https://www.douglascountyhealth.com/images/FIMR_BBC/Publications_Reports/FIMR_Annual_Community_Report_2019_-_2020_9_rs.pdf
  • Eisenbrey, D., Dunne, R. B., Fales, W., Torossian, K., & Swor, R. (2022). Describing prehospital deliveries in the State of Michigan. Curēus (Palo Alto, CA), 14(7), e26723–e26723. https://doi.org/10.7759/cureus.26723
  • Lewington-Gower, E., Masding, A., Carby, M., Downes, A., Spurr, L., Aidarous, S. A., Keating, O., Ignacio, L., & Afsar, Z. (2019). Simulation training as a tool to improve confidence in managing medical emergencies and leading cardiac arrests for core medical trainees. Clinical Medicine (London, England), 19(2), s145–s145. https://doi.org/10.7861/clinmedicine.19-2-s145
  • McLelland, G., McKenna, L., Morgans, A., & Smith, K. (2018). Epidemiology of unplanned out-of-hospital births attended by paramedics. BMC Pregnancy and Childbirth, 18(1), 15–15. https://doi.org/10.1186/s12884-017-1638-4
  • McKelvin, R., & McKelvin, G. (2020). Immersive simulation training: Comparing the impact on midwifery and paramedic students’ confidence to perform basic life support skills. Midwifery, 87, 102717–102717. https://doi.org/10.1016/j.midw.2020.102717
Sample poster thumbnail